Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure

项目摘要 关于家庭环境中的压力如何影响儿童神经发育的现有知识指出， 在全球范围内获取主要压力因素（如COVID-19大流行）的时间敏感数据的重要性 ECHO中所代表的众多人群。集体ECHO数据提供了一个不幸的洞察力 这是一个自然实验，研究这种主要压力如何影响ECHO儿童和家庭。理解这一点将 为满足受影响儿童重返学校和社区生活的需要做好更充分的准备， 同时帮助减轻今后影响儿童的灾害中类似压力因素的影响。少数群体和 边缘化人群是ECHO中美国人口患病率的代表，但任何 在55，000名ECHO儿童中，这一群体可能仍然相对较小。例如，大多数美国原住民ECHO 参与者分为2个队列，代表ECHO 55，000名儿童中的不到1500名。可以想象 对时间敏感的措施，如对ECHO的响应，将在ECHO中很少或根本没有记录 受影响最严重的边缘化人口中的参与者。 这个ECHO NOSI应用程序检查了多个不同队列中的相对流行引起的压力， 关于边缘化、COVID-19人口流行率和历史经验， 创伤/系统性种族主义。目前，这一比较包括纳瓦霍出生队列研究/ECHO (NBCS/ECHO）队列、PASS ECHO队列（南部非洲的土著和非土著人口）、 达科他州）和亚特兰大ECHO城市黑人参与者队列。我们提出三个目标，以解决我们的 流行病引起的压力将在经历最高发病率的人群中最大的总体假设 感染和死亡率，但加剧了土著和黑人人口的历史创伤。目标1将 确保在未来提供对时间敏感的数据来检验这一假设;目标2将扩大 远程和非专业人员收集神经发育数据的机会，以确保测试的可用性 目标3将测试和开发一个可靠的系统，用于将NBCS数据传输到DAC NBCS 在基础设施有限的情况下，比目前可能的频率更高。 这是第一项研究，探讨了已经受到历史影响的社区压力增加的影响。 创伤和面对像COVID-19这样的灾难，以解决集体压力是否会影响长期儿童 神经发育通过父母和家庭环境的变化，并将确保少数群体 在时间敏感的数据集中以足够的数量表示，以评估和比较 制定缓解干预措施，而不是简单地通过人口比例代表制。

Project Summary Available knowledge about how stress in the home environment influences child neurodevelopment points to the importance of capturing time-sensitive data on major stressors, such as the COVID-19 pandemic, across the many populations represented in ECHO. The collective ECHO data offers insight into an unfortunate natural experiment on how such a major stress affects ECHO children and families. Understanding this will allow for better preparation to meet the needs of affected children as they re-enter school and community life, while helping to mitigate the impacts of similar stressors in future disasters affecting children. Minority and marginalized populations are representative of US population prevalence in ECHO, but the total number of any group within the 55,000 ECHO children may still be relatively small. For example, most Native American ECHO participants are in 2 cohorts, and represent fewer than 1500 of the 55,000 children in ECHO. It is conceivable that time-sensitive measures such as responses to ECHO will be captured in very few, or none, of the ECHO participants within marginalized populations most affected. This ECHO NOSI application examines the relative pandemic-induced stress across multiple cohorts differing with respect to marginalization, COVID-19 population prevalence, and experience with historical trauma/systemic racism. At present, this comparison includes the Navajo Birth Cohort Study/ECHO (NBCS/ECHO) cohort, the PASS ECHO cohorts (Indigenous and non-Indigenous populations in South Dakota), and the Atlanta ECHO cohort of urban Black participants. We propose three aims to address our overall hypothesis that pandemic-induced stress will be greatest in populations experiencing the greatest rates of infection and mortality, but exacerbated by historical trauma in Indigenous and Black populations. Aim 1 will ensure availability of time-sensitive data to test this hypothesis in the future; Aim 2 will expand the opportunities for remote and lay staff collection of neurodevelopmental data to ensure availability for testing the hypothesis, and Aim 3 will test and develop a reliable system for transfer of NBCS data to the DAC NBCS portal at greater frequency than is currently possible with infrastructure limits. This is the first study exploring the impact of increased stress across communities already affected by historical trauma and facing a disaster like COVID-19 to address whether collective stress affects long-term child neurodevelopment through changes in parenting and the home environment, and will ensure minority cohorts are represented in the time-sensitive datasets in sufficient numbers to evaluate and compare impacts to develop mitigation interventions, rather than simply by population proportional representation.